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An In-Depth Look at Abortion Facilities in the United States

If the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization overthrows Roe v. Wade, it could have a substantial impact on the number and geographic distribution of abortion facilities nationwide. Our understanding of this landscape, based on data trends, paints a picture of significant clinic closures, creating insurmountable barriers to abortion access.

Our new report, based on information from our Abortion Facilities Database, provides an overview of the abortion facility landscape and services available across the United States from 2017 through 2021. It captures 790 publicly-advertising facilities that were open and providing abortion services in 2021, up from 774 facilities in 2017. The distribution of abortion-providing facilities, however, varied dramatically by geographic region and state, with some states having only one facility and one state having 168 facilities. This report details the abortion care landscape that people are currently navigatingbefore access could be significantly diminished.

Key Findings

While the total number of clinics increased over 2017-2021, the regions with fewer clinics experienced even more clinic loss. The South was hit hardest by clinic closures, with 48 clinic closures compared to 25 openings.
There is significant regional disparity in clinics per capita. In the South in 2021, each facility covered nearly three times the population of women of reproductive age than each facility in the Northeast.
The number of clinics that provide only medication abortion care rose, which may be because it can be provided remotely via telehealth and requires no specialized equipment. However, the rise in medication abortion provision and medication-abortion-only clinics occurred in the regions with the most clinics.
The number of facilities offering procedural abortion decreased from 538 in 2017 to 473 in 2021. This limits access for people who need care later in pregnancy.
In 2021, a total of 9 states had 2 or fewer facilities, while 6 states had only one facility (Mississippi, Missouri, North Dakota, South Dakota, West Virginia, and Wyoming).
The overturning of Roe could lead to the eventual closure of 202 clinics in the 26 states poised to ban or severely restrict abortion. This would decimate access to abortion for people living in the Southeast and Midwest where most closures would take place.

Study Design

We used data from the Abortion Facility Database, which includes data on publicly advertising abortion facilities and was systematically updated every summer during June through September of the years 2017, 2018, 2019, 2020, and 2021. In this analysis, we included all facilities that publicly advertised that they provide abortion services within all 50 U.S. states and Washington, DC. The database includes a wide range of facilities including doctor’s offices, public health centers, and hospital settings. Updates followed a structured process, including initial online searches to identify abortion facilities throughout the U.S. and mystery shopper calls to confirm and obtain additional information from the facilities from the perspective of a potential patient. Each year we checked data for all facilities in the database against the prior year, identified any changes—including closures—and added any facilities that had newly begun to offer abortion care.

Implications

The overturning of Roe v. Wade could lead to the eventual closure of 202 facilities across these states, which would shutter 26% of all publicly advertising facilities in the U.S., particularly decimating abortion access for pregnant people living in the South and Midwest where most of these closures would occur. Based on research, the majority of abortion patients are low-income, and our trends report suggests that economic and logistical pressures on people seeking abortion will only be intensified.

To learn more, read the report Trends in Abortion Care in the United States, 2017-2021.

Map 1 for Trends Report 2017-2021 Landing Page
Figure 1. Number of publicly-advertising abortion facilities in 2021, by state.
Map 2 for 2017-2021 Trends Report Landing Page
Figure 2. Estimated number of women of reproductive age per each abortion facility in 2021, by state.